scholarly journals Clinical features and aetiology of cerebral palsy in children from Cross River State, Nigeria

2020 ◽  
Vol 105 (7) ◽  
pp. 625-630 ◽  
Author(s):  
Roseline Duke ◽  
Chimaeze Torty ◽  
Kennedy Nwachukwu ◽  
Soter Ameh ◽  
Min Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Management Strategies ◽  
Birth Asphyxia ◽  
Population Based ◽  
System Level ◽  
Middle Income ◽  
Cross River State ◽  
Level 1

ObjectiveThere are few studies on cerebral palsy (CP) in African children and our study aimed to describe the aetiology, characteristics and severity of CP in children from Nigeria.DesignA population-based study using key informant methodology (KIM) was conducted as part of a clinical research trial. Children aged 4–15 years were clinically assessed for CP.ResultsThe estimated prevalence of CP using KIM was 2.3/1000 children (95% CI 2.0 to 2.5/1000). 388 children were diagnosed with CP, with Gross Motor Function Classification System level 1 in 70 (18.1%), II in 156 (40.2%), III in 54 (13.9%), IV in 54 (13.9%), V in 54 (13.9%). 300/388 (77.3%) had Manual Ability Classification Scale of level 1–3 and 88 (22.7%) of level 4–5. CP types were spastic in 271 (70%), with 60% of these bilateral and 40% unilateral, ataxic 38 (9.8%), dystonic 18 (4.6%), choreoathetoid 29 (7.5%) and unclassifiable 32 (8.3%). Postneonatal risk factors for CP were seen in 140 (36.1%) children including malaria with seizures 101/140 (72.1%), malaria with coma 21/140 (15.0%), meningitis 12/140 (8.6%), tuberculosis 2/140 (1.4%), sickle cell disease 3/140 (2.2%), HIV 1/221 (0.7%). Prenatal/perinatal risk factors were seen in 248 (63.9%%), birth asphyxia 118 (47.6%) and clinical congenital rubella syndrome 8 (3.3%) and hyperbilirubinaemia 59 (23.8%) were identified as preventable risk factors for CP.ConclusionThe profile of CP in this population is similar to that found in other low-income and middle-income countries (LMIC). Some risk factors identified were preventable. Prevention and management strategies for CP designed for LMIC are needed.

scholarly journals Prevalence and risk factors for wheeze, decreased forced expiratory volume in 1 s and bronchoconstriction in young children living in Havana, Cuba: a population-based cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034192
Author(s):  
Ramón Suárez-Medina ◽  
Silvia Venero-Fernández ◽  
Vilma Alvarez-Valdés ◽  
Nieves Sardiñas-Baez ◽  
Carmona Cristina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Young Children ◽  
Low Income ◽  
Inhaled Corticosteroids ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
First Year ◽  
Middle Income ◽  
Middle Income Countries

ObjectivesAsthma has not been extensively studied in low-income and middle-income countries, where risk factors and access to treatment may differ from more affluent countries. We aimed to identify the prevalence of asthma and local risk factors in Havana, Cuba.SettingFour municipalities in Havana, Cuba.ParticipantsA population-based cohort study design of young children living in Havana, Cuba. Children were recruited from primary care centres at age 12–15 months.Primary and secondary outcome measuresData on wheeze in the past 12 months, asthma treatment and environmental exposures collected regularly until the age of 6 years, when forced expiratory volume in 1 s (FEV1) and reversibility to aerosolised salbutamol were also measured.Results1106 children provided data at the age of 6 years old. The prevalence of wheeze in the previous 12 months was 422 (38%), and 294 (33%) of the study population had bronchodilatation of 12% or more in FEV1after administration of inhaled salbutamol. In the previous 12 months, 182 (16%) of the children had received inhaled corticosteroids, 416 (38%) salbutamol inhalers and 283 (26%) a course of systemic steroids.Wheeze in the first year and a family history of asthma were both positively associated with bronchodilatation to inhaled salbutamol (1.94%; 95% CI 0.81 to 3.08 and 1.85%; CI 0.14 to 3.57, respectively), while paracetamol use in the first year was associated with wheeze at 6 years (OR 1.64, 95% CI 1.14 to 2.35). There were large differences in FEV1, bronchodilatation and risk of wheeze across different geographical areas.ConclusionsAsthma is common in young children living in Havana, and the high prevalence of systemic steroids administrated is likely to reflect the underuse of regular inhaled corticosteroids. If replicated in other comparable low-income and middle-income countries, this represents an important global public health issue.

scholarly journals Clinical Profile of Birth Asphyxia in Dhulikhel Hospital: A Retrospective Study

1970 ◽  
Vol 30 (3) ◽  
pp. 141-146 ◽  
Author(s):  
S Dongol ◽  
J Singh ◽  
S Shrestha ◽  
A Shakya
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Birth Asphyxia ◽  
Clinical Information ◽  
World Health ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Neonatal Deaths ◽  
Live Births ◽  
Infant Birth

Introduction: Birth asphyxia is defined by the World Health Organization "the failure to initiate and sustain breathing at birth." The WHO has estimated that 4 million babies die during the neonatal period every year and 99% of these deaths occur in low-income and middle income countries. Three major causes account for over three quarters of these deaths, serious infection (28%) complication of preterm birth (26%) and birth asphyxia (23%). This estimation implies that birth asphyxia is the cause of around one million neonatal deaths each year. One of the present challenges is the lack of a gold standard for accurately defining birth asphyxia. Because of same reason the incidence of birth asphyxia is difficult to quantify. Objective: The aim of this study was to assess the prevalence of birth asphyxia, identify the common obstetric and neonatal risk factors, and study the cause of death. Methodology: All babies born in Dhulikhel Hospital (DH) from Jan 2007 to Oct 2009 with a diagnosis of birth asphyxia (5 min Apgar < 7 and those with no spontaneous respirations after birth) were included in the study (n=102). Clinical information was collected retrospectively from maternal records (maternal age, gravida, type of delivery, presence of meconium, induced or spontaneous labour, and pregnancy complications). The NICU records provided additional information about new born infant (birth asphyxia, stages of birth asphyxia, birth weight, sex and subsequent mortality). Results: Among the 3784 live births there were 102 babies with birth asphyxia prevalence of 26.9/1000 live births. Babies with Hypoxic ischemic encephalopathy (HIE) Stage 1 had a very good outcome but HIE III was associated with a poor outcome. Males, primipara and pregnancies with complications were associated with a higher rate of birth asphyxia. Septicaemia, necrotizing enterocolitis, preterm delivery, convulsion and, pneumothorax were associated with higher mortality and morbidity. Conclusion: Birth asphyxia was one of the commonest causes of admission and mortality in NICU. Babies with HIE Stage III had a very poor prognosis. Birth asphyxia combined with other morbidities was associated with a higher mortality. Sepsis is the commonest morbidity in cases of birth asphyxia. Maternal gravida, pregnancy complication with PROM, meconium, APH, emergency caesarean section, preterm and male sex were the risk factors for birth asphyxia. Key words: Birth asphyxia; HIE; Neonatal sepsisDOI: 10.3126/jnps.v30i3.3916J Nep Paedtr Soc 2010;30(3):141-146

scholarly journals Prevalence of chronic kidney disease and risk factors in North-Central Nigeria: a population-based survey

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Timothy Olusegun Olanrewaju ◽  
◽  
Ademola Aderibigbe ◽  
Ademola Alabi Popoola ◽  
Kolawole Thomas Braimoh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Management Strategies ◽  
Central Zone ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
North Central ◽  
Kidney Length

Abstract Background Chronic kidney disease (CKD) is a growing challenge in low- and middle-income countries, particularly in sub-Saharan Africa. There is insufficient population-based data on CKD in Nigeria that is required to estimate its true burden, and to design prevention and management strategies. The study aims to determine the prevalence of CKD and its risk factors in Nigeria. Methods We studied 8 urban communities in Kwara State, North-Central zone of Nigeria. Blood pressure, fasting blood sugar, urinalysis, weight, height, waist circumference and hip circumference were obtained. Albuminuria and kidney length were measured by ultrasound while estimated glomerular filtration rate (eGFR) was derived from serum creatinine, using chronic disease epidemiology collaboration (CKD-EPI) equation. Associations of risk factors with CKD were determined by multivariate logistic regression and expressed as adjusted odds ratio (aOR) with corresponding 95% confidence intervals. Results One thousand three hundred and fifty-three adults ≥18 years (44% males) with mean age of 44.3 ± 14.4 years, were screened. Mean kidney lengths were: right, 93.5 ± 7.0 cm and left, 93.4 ± 7.5 cm. The age-adjusted prevalence of hypertension was 24%; diabetes 4%; obesity 8.7%; albuminuria of > 30 mg/L 7%; and dipstick proteinuria 13%. The age-adjusted prevalence of CKD by estimated GFR < 60 ml/min/1.73m2 and/or Proteinuria was 12%. Diabetes (aOR 6.41, 95%CI = 3.50–11.73, P = 0.001), obesity (aOR 1.50, 95%CI = 1.10–2.05, P = 0.011), proteinuria (aOR 2.07, 95%CI = 1.05–4.08, P = 0.035); female sex (aOR 1.67, 95%CI = 1.47–1.89, P = 0.001); and age (aOR 1.89, 95%CI = 1.13–3.17, P = 0.015) were the identified predictors of CKD. Conclusions CKD and its risk factors are prevalent among middle-aged urban populations in North-Central Nigeria. It is common among women, fueled by diabetes, ageing, obesity, and albuminuria. These data add to existing regional studies of burden of CKD that may serve as template for a national prevention framework for CKD in Nigeria. One of the limitations of the study is that the participants were voluntary community dwellers and as such not representative for the community. The sample may thus have been subjected to selection bias possibly resulting in overestimation of CKD risk factors.

scholarly journals Cerebral palsy risk factors: international experience

2020 ◽  
Vol 159 ◽  
pp. 08006
Author(s):  
Raushan Issayeva ◽  
Aigerim Aliakparova ◽  
Symbat Abzaliyeva ◽  
Gulzhan Kassenova ◽  
Gulnara Tashenova
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Asphyxia ◽  
Population Based ◽  
Hereditary Diseases ◽  
Surveillance Programs ◽  
Exact Etiology ◽  
Common Risk Factors ◽  
Real Picture ◽  
Post Infectious

This review article aims to outline several risk factors for the Cerebral Palsy (CP) development worldwide. CP is the most prevalent disabling condition in children that imposes a significant socio-economical responsibility on the system of the health care. Despite a solid body of extant research, the exact etiology of CP remains unknown. There are several risk factors that may be triggering CP development at pre-, intra- and postnatal periods, particularly, gestational age, birth weight, mother's health, placental abnormalities, thrombophillia, asphyxia, brain ischemia and multiple pregnancies. According to extant literature, the majority of CP cases develop within antenatal period in high-income countries. Contrastingly, in developing countries, there is a slightly higher proportion of a postnatally acquired CP cases linked to post-infectious brain damage following meningitis, septicaemia, as well as other conditions, such as malaria. However, these studies were of a small size and not case-controlled or population-based, which significantly curtails the results and underestimating the real picture. With very small number of survivors of early preterm, common risk factors identified to be the maternal rhesus allergenic immunization and birth asphyxia, or hereditary diseases, such as dehydrogenase of glucose-6-phosphate (G6PD) deficiency and encephalopathy of subsequent bilirubin. According to standardized data from international surveillance programs, important risk factors are strongly associated with CP development in most countries.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

scholarly journals Stillbirth 2010–2018: a prospective, population-based, multi-country study from the Global Network

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Elizabeth M. McClure ◽  
Sarah Saleem ◽  
Shivaprasad S. Goudar ◽  
Ana Garces ◽  
Ryan Whitworth ◽  
...  
Keyword(s):  
Democratic Republic Of Congo ◽  
Birth Asphyxia ◽  
Obstetric Care ◽  
Population Based ◽  
Global Network ◽  
Substantial Decrease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Assisted Delivery

Abstract Background Stillbirth rates are high and represent a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). In LMIC, where nearly 98% of stillbirths worldwide occur, few population-based studies have documented cause of stillbirths or the trends in rate of stillbirth over time. Methods We undertook a prospective, population-based multi-country research study of all pregnant women in defined geographic areas across 7 sites in low-resource settings (Kenya, Zambia, Democratic Republic of Congo, India, Pakistan, and Guatemala). Staff collected demographic and health care characteristics with outcomes obtained at delivery. Cause of stillbirth was assigned by algorithm. Results From 2010 through 2018, 573,148 women were enrolled with delivery data obtained. Of the 552,547 births that reached 500 g or 20 weeks gestation, 15,604 were stillbirths; a rate of 28.2 stillbirths per 1000 births. The stillbirth rates were 19.3 in the Guatemala site, 23.8 in the African sites, and 33.3 in the Asian sites. Specifically, stillbirth rates were highest in the Pakistan site, which also documented a substantial decrease in stillbirth rates over the study period, from 56.0 per 1000 (95% CI 51.0, 61.0) in 2010 to 44.4 per 1000 (95% CI 39.1, 49.7) in 2018. The Nagpur, India site also documented a substantial decrease in stillbirths from 32.5 (95% CI 29.0, 36.1) to 16.9 (95% CI 13.9, 19.9) per 1000 in 2018; however, other sites had only small declines in stillbirth over the same period. Women who were less educated and older as well as those with less access to antenatal care and with vaginal assisted delivery were at increased risk of stillbirth. The major fetal causes of stillbirth were birth asphyxia (44.0% of stillbirths) and infectious causes (22.2%). The maternal conditions that were observed among those with stillbirth were obstructed or prolonged labor, antepartum hemorrhage and maternal infections. Conclusions Over the study period, stillbirth rates have remained relatively high across all sites. With the exceptions of the Pakistan and Nagpur sites, Global Network sites did not observe substantial changes in their stillbirth rates. Women who were less educated and had less access to antenatal and obstetric care remained at the highest burden of stillbirth. Study registration Clinicaltrials.gov (ID# NCT01073475).

scholarly journals Hemiplegic (unilateral) cerebral palsy in northern Stockholm: clinical assessment, brain imaging, EEG, epilepsy and aetiologic background factors

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Elsa Tillberg ◽  
Bengt Isberg ◽  
Jonas K. E. Persson
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
White Matter ◽  
Diagnostic Delay ◽  
Motor Impairment ◽  
Population Based ◽  
White Matter Injury ◽  
Background Factors ◽  
Hemiplegic Cerebral Palsy ◽  
First Year Of Life

Abstract Background The purpose of this study was to describe clinical presentation, epilepsy, EEG, extent and site of the underlying cerebral lesion with special reference towards aetiologic background factors in a population-based group of children with hemiplegic cerebral palsy. Methods Forty-seven children of school- age, fulfilling the SPCE (Surveillance of Cerebral palsy in Europe)-criteria of hemiplegic cerebral palsy, identified via the Swedish cerebral palsy register, were invited and asked to participate in the study. Results Fifteen boys and six girls participated. Of the sixteen children born at term, five had no risk factors for cerebral palsy. Two out of five preterm children presented additional risk factors. Debut of motor impairment was observed in the first year of life in sixteen children. Age at diagnosis varied from 2 months to 6 years. Epilepsy was common and associated with grey- and white matter injury. Conclusions Recognizing the importance of risk factors for cerebral palsy, any child with these risk factors should be offered a check-up by a paediatrician or a paediatric neurologist. Thereby reducing diagnostic delay. Epilepsy is common in hemiplegic cerebral palsy and associated with grey- and white matter injury in this cohort.

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